Impaired insulin receptor binding and postbinding defects of adipocytes from normal and diabetic pregnant women

To evaluate the relative contribution of insulin binding and postbinding defects of glucose utilization in peripheral tissue during normal and diabetic pregnancy, we have studied the in vitro insulin action of isolated adipocytes from eight nondiabetic pregnant women and nine pregnant women with insulin-dependent diabetes mellitus who were undergoing cesarian section. The pregnant women were compared with a matched group of normal nonpregnant women undergoing gynecologic surgery. Insulin binding to adipocytes measured at tracer insulin concentration was reduced by 45% (P less than 0.01) in normal pregnant women and by 30% (P less than 0.02) in pregnant women with diabetes. In contrast, no changes were found between the three groups in insulin binding to pure monocytes and erythrocytes. The glucose transport system in fat cells from both groups of pregnant women was characterized by impaired maximal (P less than 0.05) and half-maximal (P less than 0.05) response to insulin. When fat cell glucose metabolism was studied, pregnant diabetic women exhibited decreased basal lipogenesis (P less than 0.05) and decreased maximal responses of lipogenesis and glucose oxidation to insulin stimulation (P less than 0.05). Similar but less pronounced abnormalities were seen in glucose metabolism of adipocytes from nondiabetic pregnant women. In conclusion, both in late normal and diabetic pregnancy, insulin binding to adipocytes is significantly reduced and accompanied by decreased insulin sensitivity and reduced maximal insulin responsiveness of glucose transport and by impaired basal and maximally insulin-stimulated glucose metabolism.     

Hexamethyldisilazane in preparation of retinal tissue for scanning electron microscopy

A new rapid procedure for desiccating frozen resin-cracked retinal tissue for scanning electron microscopy (SEM) which permits air-drying was found to compare favorably with tissues prepared by critical-point drying: Retinal tissue was fixed in 4% phosphate-buffered neutral formaldehyde, dehydrated by means of graded ethanol, embedded in Epon, cracked and washed in propylene oxide. For desiccation, the specimens were immersed in hexamethyldisilazane (HMDS), air-dried and finally sputter-coated. The method is time-saving, gives extended information in SEM, and the number of good specimens is increased.     

Neonatal reference values for ionized calcium, phosphate and magnesium. Selection of reference population by optimality criteria

Thirty-one full-term newborn babies were investigated in order to establish reference values for ionized calcium. Only children fulfilling certain optimality criteria (with best possible maternal and infant conditions and uncomplicated pregnancy and delivery) were included. All infants were breast fed. Capillary blood for analysis of ionized calcium was collected by heel puncture on day 1 (6-36 h post partum, p.p.), day 3 (60-84 h p.p.) and day 5 (108-132 h p.p.). Ionized calcium was measured with a semi-automatic electrode system ICA 1 (Radiometer A/S, Copenhagen, Denmark). The reference ranges (mean +/- 2 SD) for days 1, 3 and 5 were 1.05-1.37, 1.10-1.42 and 1.20-1.48 mmol/l, respectively. The mean ionized calcium concentration on day 1 was significantly lower than on days 3 and 5. Reference values are also given for total calcium, magnesium and phosphate. We emphasize that it is impossible to calculate ionized calcium from total calcium or vice versa.     

On the origin of apparent low tissue signals in balanced SSFP.

Balanced steady-state free precession (bSSFP) has become increasingly important in clinical applications. Its signal properties have been investigated over several years by many groups, and various critical factors for bSSFP signal intensity and stability, such as off-resonances, flow, and eddy currents, have been identified. It is generally accepted that bSSFP signal intensity is a function of relaxation times, excitation angles, and spin densities only. While this is true for simple phantoms, it appears that signals from tissues are significantly less intense than predicted by theory. This work demonstrates that the molecular origin of this apparent signal reduction is due to on-resonance magnetization transfer (MT). High flip angles in combination with very short repetition times (TRs), as commonly used for bSSFP, lead to a considerable saturation in the fraction of macromolecular (MM) pool protons. As a result, bSSFP signal is strongly attenuated by up to a factor of 2 in the human brain compared to the signal expected from theory.     

Doppler echocardiography of 119 normal-functioning St Jude Medical mitral valve prostheses: a comprehensive assessment including time-velocity integral ratio and prosthesis performance index.

The purpose of this study was to provide, in a large number of patients, comprehensive Doppler echocardiographic assessment of normal St Jude Medical mitral valve prosthesis function using Doppler-derived hemodynamic variables, including the mitral valve prosthesis-to-left ventricular outflow tract time-velocity integral ratio and prosthesis performance index. The pressure half-time was less than 130 milliseconds in all patients, and all but one patient had either a peak early mitral diastolic velocity of 2 m/s or less or a mitral valve prosthesis-to-left ventricular outflow tract time-velocity integral ratio of less than 2.2. There was a significant (P < .001) negative correlation between the prosthesis performance index and prosthesis size. This negative correlation suggests that there is more efficient use of the in vitro geometric orifice area with smaller prostheses.